What should you know about nasal syphilis?

Syphilis is an infection that can affect different parts of the body. Nasal involvement may cause a sore, crusting, discharge, blockage, nosebleed or changes in smell, but these symptoms also have many non-sexually transmitted causes. A nasal symptom does not establish syphilis, and syphilis can sometimes have few obvious symptoms. A clinician will consider sexual and medical history, examine the affected area and look for symptoms elsewhere. Testing is the reliable way to clarify the diagnosis.

Arrange an STI screening appointment if you have a new nasal lesion or symptoms after possible sexual exposure, or if a partner has been diagnosed. Avoid sexual contact until a clinician explains the precautions that apply to your situation, and do not share prescribed medicine. Tell the clinician about pregnancy, allergies, previous syphilis, other medicines and any neurological or eye symptoms. If testing confirms syphilis, antibiotic treatment is selected according to the stage and clinical findings; follow-up helps confirm that care is complete and partners can be addressed.

Seek prompt medical advice for a persistent nasal sore, unexplained crusting or bleeding, new rash, swollen glands or a known exposure. Seek urgent care for eye pain or vision change, severe headache, confusion, weakness, hearing change or other new neurological symptoms, because syphilis can involve organs beyond the nose. A rapidly worsening facial infection or difficulty breathing also needs urgent assessment.

Ask which tests are needed, whether the nasal finding needs a swab or another examination, and whether testing for other infections is appropriate. Ask when results will be available, what treatment is recommended if positive, how follow-up works, and how to notify or protect partners.